Provider Demographics
NPI:1871171363
Name:PARSLEY, LOGAN BLAINE (MSW, CSW-I)
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:BLAINE
Last Name:PARSLEY
Suffix:
Gender:M
Credentials:MSW, CSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 VINEYARD WAY
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-5323
Mailing Address - Country:US
Mailing Address - Phone:775-220-1608
Mailing Address - Fax:
Practice Address - Street 1:755 N ROOP ST STE 101
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-3107
Practice Address - Country:US
Practice Address - Phone:775-220-1608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-16991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical